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Topic

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Supratrochlear veins

The supratrochlear veins are paired superficial veins of the forehead that ascend from the bridge of the nose and medial forehead and run upward near the midline, close to the supratrochlear artery. They drain into the angular vein, which continues inferiorly to join the facial vein. Superiorly, they communicate with the supraorbital veins, which in turn connect to the ophthalmic veins. These venous connections establish an important pathway between the facial vein and the cavernous sinus, forming part of the so-called “danger triangle” of the face, where infection can spread intracranially.

Synonyms

  • Frontal medial veins

  • Medial forehead veins

  • Tributaries of angular vein

Function

  • Drain venous blood from the medial forehead and glabella region

  • Empty into the angular vein at the medial canthus of the eye

  • Communicate with the supraorbital and ophthalmic veins, linking extracranial and intracranial venous systems

  • Clinically significant in infection spread, venous thrombosis, and surgical planning

MRI Appearance

T1-weighted images:

  • Supratrochlear veins appear as flow voids (signal loss) due to fast venous blood flow

  • May be faintly visible with surrounding soft tissue contrast

T2-weighted images:

  • Also appear as flow voids; surrounding fat and subcutaneous tissues are hyperintense, providing contrast

  • Thrombosed veins may appear as hyperintense tubular structures rather than voids

MRV (Magnetic Resonance Venography):

  • Clearly demonstrates the course of the supratrochlear veins, their junction with the angular vein, and communication with the supraorbital and ophthalmic veins

  • Normal veins show bright signal within the lumen

  • MRV is excellent for evaluating venous thrombosis, obstruction, or abnormal collateral formation

T1 Post-Contrast (Gadolinium-enhanced MRI):

  • Veins demonstrate homogeneous enhancement of the lumen

  • Useful for detecting small venous channels or thrombotic occlusion

CT Appearance

Non-contrast CT:

  • Veins are not well visualized unless thrombosed (may appear as hyperdense tubular structures)

  • Surrounded by subcutaneous fat and bone of the frontal region

CT Venography (CTV):

  • Veins are opacified with contrast, clearly demonstrating their course from the medial forehead into the angular vein

  • Shows communications with the supraorbital and ophthalmic veins

  • CTV is especially useful for evaluating venous thrombosis, cavernous sinus connections, or surgical planning

MRI images

Supratrochlear Veins